February 19th, 2011 by AnnMacDonald in Health Tips, Research
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A paper published in the February issue of Health Affairs — discussed at length in an article in the New York Times — contains the sort of blunt, plain-spoken language you seldom read in academic journals. The authors, who include some of the most prominent neuroscientists and ethicists in the world, warn that manufacturers are misusing the FDA’s humanitarian device exemption to promote deep brain stimulation as a “treatment” for obsessive compulsive disorder (OCD).
In fact, they make clear that deep brain stimulation is very much an experimental procedure. Research is still at an early stage, and the risks to patients are not well defined. When suffering is severe and no other treatment has provided relief, there is value in making available an intervention like deep brain stimulation. But misleading or biased information, no matter where it comes from, certainly undermines patients’ ability to calculate benefits and risks.
To enable deep brain stimulation, a surgeon must first implant electrodes in the brain and connect them to a pair of small electrical generators underneath the collarbone. Deep brain stimulation uses electricity to affect how brain signals are transmitted in particular areas of the brain. The image to the left, from the National Institute of Mental Health, shows how deep brain stimulation depends on the implantation of pulse generators below the collarbone and electrodes in the brain.
Specific concerns are raised by the article in Health Affairs (and in our own article on this topic last year in the Harvard Mental Health Letter). Read more »
*This blog post was originally published at Harvard Health Blog*
February 13th, 2011 by AnnMacDonald in Better Health Network, Health Tips
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This is the time of year when stores are filled with red hearts and other reminders that Valentine’s Day is approaching. It’s a mood booster, not to mention a nice break from all that winter grey (at least up here in Boston). After all, what would life be like without romance, love — and sex?
Unfortunately, a variety of health problems — as well as some of the treatments for them — can get in the way of sexual desire and functioning. Here’s a quick look at some of the main sources of trouble and suggestions about what to try first. If these initial strategies don’t work, have a heart to heart with your doctor about what to do next. There may not be a quick fix for health-related sexual problems, but there are steps you can take to help ensure that you can still enjoy a love life while taking care of the rest of your health.
Arthritis
Arthritis comes in many guises, but most forms of this disease cause joints to become stiff and painful. The limitations on movement can interfere with sexual intimacy — especially in people with arthritis of the knees, hips, or spine.
One common solution is to try different positions to find a way to make sex physically more comfortable. Another option is to take a painkiller or a warm shower before sex to ease muscle pain and joint stiffness. Or try a waterbed — which will move with you.
You can read more online by viewing this helpful article posted by the American College of Rheumatology.
Cancer
Cancer treatment may have long-term impact on sexual desire and functioning. Surgery or radiation in the pelvic region, for example, can damage nerves, leading to loss of sensation and inability to have an orgasm in women and erectile dysfunction in men. Chemotherapy can lower sex drive in both men and women. Read more »
*This blog post was originally published at Harvard Health Blog*
February 11th, 2011 by John Mandrola, M.D. in Opinion, Research
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I’d like to talk about how rodents, relationships, and riding relate to overall health and wellness.
This idea comes from a nicely-written New York Times piece entitled, “Does Loneliness Reduce the Benefits of Exercise?” Here, Gretchen Reynolds reviews a few intriguing studies about how relationships may affect exercise, stress hormone levels, and intelligence. The combo caught my eye.
Anyone who pays attention to wellness knows that exercise produces more flexible arteries, more durable hearts, and leaner body shapes. These benefits are obvious, and honestly, sometimes a bit tiresome to write about.
To me, a far more interesting — and lesser known — benefit of regular exercise is that it might make us smarter. Here’s where the rodents come into the story.
As was summarized in the New York Times piece, when researchers allowed rats and mice access to running wheels they observed (a) that they all ran, and (b) those rats that did run scored better on rodent IQ tests, and actually grew more brain cells. This is a striking finding because nerve cells — unlike blood, GI and skin cells, which turnover rapidly — grow very slowly, if at all.
But that’s not the entire story. The Princeton researchers wanted to know whether the rat’s social relationships could have measurable biologic effects.
It turns out that rodents — like humans — are quite social. So social, in fact, that in these trials the brain-growing effect of exercise was blunted when rodents lived alone. Compared to rats and mice that lived in groups, those that were kept in isolation failed to grow new nerve cells in response to exercise. And importantly, isolated rats produced higher levels of stress hormones than those who lived in groups, even though both groups ran the same distance. Read more »
*This blog post was originally published at Dr John M*
February 10th, 2011 by Elaine Schattner, M.D. in Better Health Network, Opinion
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[Recently] I came upon a Jan 24 op-ed, “A Fighting Spirit Won’t Change Your Life” by Richard Sloan, Ph.D., of Columbia University’s psychiatry department. Somehow I’d missed this worthwhile piece on the sometimes-trendy notion of mind-over-matter in healing and medicine.
Sloan opens with aftermath of the Tucson shootings:
…Representative Giffords’s husband describes her as a “fighter,” and no doubt she is one. Whether her recovery has anything to do with a fighting spirit, however, is another matter entirely.
He jumps quickly through a history of the mind cure movement in America: From Phineas Quimby’s concept of illness as a product of mistaken beliefs — to William James and “New Thought” ideas — to Norman Vincent Peale’s 1952 “Power of Positive Thinking” — to more current takes on the matter. These ideas, while popular, are not reality-based.
In his words:
But there’s no evidence to back up the idea that an upbeat attitude can prevent any illness or help someone recover from one more readily. On the contrary, a recently completed study* of nearly 60,000 people in Finland and Sweden who were followed for almost 30 years found no significant association between personality traits and the likelihood of developing or surviving cancer. Cancer doesn’t care if we’re good or bad, virtuous or vicious, compassionate or inconsiderate. Neither does heart disease or AIDS or any other illness or injury.
*Am. J. Epidemiol. (2010) 172 (4): 377–385.
The New York Times printed several letters in response, most of which point to pseudo-evidence on the matter. All the more reason to bolster public education in the U.S. — people won’t be persuaded by charismatic, wishful thinking about healthcare.
It happens I’m a fan of Joan Didion’s. I was so taken by the “Year of Magical Thinking,” in fact, that I read it twice. Irrational responses — and hope — are normal human responses to illness, disappointment, and personal loss. But they’re not science. It’s important to keep it straight.
*This blog post was originally published at Medical Lessons*
February 8th, 2011 by GarySchwitzer in News, Research
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Reuters Health reports that more than a quarter of Americans taking antidepressants have never been diagnosed with any of the conditions the drugs are typically used to treat, according to new research published in the Journal of Clinical Psychiatry. An excerpt:
“We cannot be sure that the risks and side effects of antidepressants are worth the benefit of taking them for people who do not meet criteria for major depression,” said Jina Pagura, a psychologist and currently a medical student at the University of Manitoba in Canada, who worked on the study.
“These individuals are likely approaching their physicians with concerns that may be related to depression, and could include symptoms like trouble sleeping, poor mood, difficulties in relationships, etc.,” she added in an e-mail to Reuters Health. “Although an antidepressant might help with these issues, the problems may also go away on their own with time, or might be more amenable to counseling or psychotherapy.”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
